Self-management of reflux symptoms after esophagectomy in China: A qualitative study

Objective: This qualitative study aimed to explore the self-management experiences, expectations, and needs of Chinese patients experiencing reflux symptoms after esophagectomy, guided by the Integrated Theory of Health Behavior Change (ITHBC). Methods: Semi-structured interviews were conducted with 18 patients who had undergone esophagectomy, selected via maximum variation sampling. Data were analyzed using directed content analysis based on the ITHBC framework, focusing on three domains: knowledge and beliefs, self-regulation skills, and social facilitation. Results: Our analysis identified three core themes reflecting significant gaps in current supportive care: the need for actionable knowledge, as patients struggled with complex medical information and desired simplified explanations, standardized symptom assessment, and long-term risk management guidance; the need for personalized self-regulation skills, with difficulties reported in implementing dietary adjustments, posture management, and self-monitoring due to a lack of tailored guidance; and the need for continuous and collaborative support, as existing support from health care providers, family, and peers was often fragmented or insufficient. These findings underscore a systemic misalignment between patient needs and clinical support, highlighting an urgent demand for more integrated, practical, and accessible self-management resources. Conclusions: Significant gaps exist between patient needs and current supportive care practices. There is an urgent need for tailored interventions, including metaphor-based education, structured skill training, enhanced social support, and digitally accessible micro-learning resources, to improve self-management outcomes in this population.